Quintessence Publishing Blog

Quintessence Publishing: A Look Behind the Scenes

Posted on May 22, 2020 by Quintessence Publishing

Reading time: 5 minutes

Written by: Bryn Grisham

Quintessence exhibits at dental meetings throughout the world.

Whenever I go to dental meetings, I overhear people talk about what great books Quintessence publishes and how beautiful they are. Comments like that are golden and I couldn’t agree more. But most people don’t realize just what an outlier Quintessence is, not just in the quality of our books but also in our whole approach.

Quintessence stands alone as the last independent dental publisher.

By publishing standards, Quintessence is a tiny company, which is rare in this era. Over the last 20 years, all the small dental publishers have been absorbed by huge medical publishers. Quintessence stands alone as the last independent dental publisher. How have we been able to do it? Part of our continued success has been our laser focus on our products. We only do dental books, nothing else, and we make sure they are simply the best dental books in topic, content, and overall presentation.

Renowned orthodontist David Sarver is no stranger to dental books, and when he started looking for a publisher for his latest book, he came to Quintessence. His reason? It was all about the visual quality: “I chose Quintessence as my publisher because of its superb handling of imagery and layout. My book is about esthetics, and it was important to me to be an esthetic book itself. That goal was achieved: as you open the pages the photography just leaps off the page.”

Excellence doesn’t happen by accident.

That kind of excellence doesn’t happen by accident. First, you can’t have esthetics without quality images. Quintessence understood that principle from the beginning, and we take great care that our authors’ images look great on the printed page. We also know that color correction is important to printing vibrant pictures. In publishing, it is standard to color correct images to match blacks and grays throughout an entire book. But how do you find color technicians who are skilled in the subtle colors of enamel, dentin, and gingiva or understand how saturated blood should look in surgical images? In turns out, you don’t find them anywhere. We know because we tried, and in the end we realized we had to train our own color technicians to work exclusively with dental images. They are masters at what they do, and that is why they nail it every time.

Quintessence’s team of expert color technicians.

“A good editor is like a pair of Spanx: firming up the body, making the subject look good, and absolutely invisible.”—Sandi Layne

But Quintessence publishes more than just the art books of the dental world. Content is king and that is by intention too. Most of our time and energy goes into superb clinical manuals and textbooks that illustrate protocols step by step. We are lucky to work with some of the best dentists and oral surgeons in the world—clinicians who not only know their craft extremely well but also recognize how to document and explain what they do to achieve their results. It takes a very savvy writer to do that, but the savviest writers know they need an exceptional editor who really knows her bookcraft and can seamlessly translate their raw materials into a stylish and well-appointed book. Fiction author Sandi Layne describes the essential role of an editor best: “A good editor is like a pair of Spanx: firming up the body, making the subject look good, and absolutely invisible.”

Quintessence consistently publishes the best new books in dentistry.

Other publishers have an assembly line structure, which means that a manuscript is passed through the hands of a series of different editors, each providing a discrete task. In contrast, at Quintessence, each book project is assigned to one editor who sees the project through, from submission to publication. As senior editor Leah Huffman explains, this “leads to a close working relationship between the editor and the author, which undoubtedly leads to a better product because the author and editor are listening to each other and making decisions together. Our authors will tell you that this makes their experience working with Quintessence enjoyable and successful.”

The bottom line is that Quintessence cultivates excellence in publishing by working with people (both authors and talented staff) who really care about dental books and bring their best to their projects, every time. When that is the way you work, people are going to notice.

Renowned orthodontist Sandra Tai at the Quintessence office in Illinois.

“What sets Quintessence apart is their attention to detail and quality of their work.”—Richard Miron

Author Richard Miron, a biomaterials researcher and oral surgeon, has written several textbooks and book chapters with various publishers, but once he started working with Quintessence, he never looked back. “What sets Quintessence apart is their attention to detail and quality of their work. The core staff has all been at Quintessence for 10+ years and has gained tremendous knowledge and know-how along the way. They simply understand how to bring the best out of each author, and this passion of theirs has been the cornerstone of their reputation over many decades.”

Quintessence does have a reputation for publishing great books, and given the intention and focus of everyone involved, our reputation is well deserved. The goal has always been to elevate the dental industry by publishing the best dental books, and we’d like nothing more than for other publishers to follow our lead, but for now we will continue to do what we do best and set the standard. And, of course, if you notice how good our books are, don’t hesitate to let us know.

Bryn Grisham is the Director of Book Publications at Quintessence Publishing. She has been with Quintessence for more than 15 years.

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Systematic Treatment Planning in Orthodontics

Posted on May 15, 2020 by Quintessence Publishing

Reading time: 6 minutes

Written by: Leah Huffman

Orthodontics as a dental specialty is known for having many camps within it and many subgroups of people following a specific philosophy. Take cephalometry, for example. You have the Steiner system, the McNamara system, and the Wits, Downs, Björk, Tweed, Jarabak, and Ricketts systems, among others. And then there’s the appliances orthodontists swear by: headgear, face mask, palatal expanders, molar distalizers, Twin Block, Bionator, Forsus, Frankel, elastics, retainers, and many, many more. It’s easy to see how orthodontists can get bogged down in the different theories and techniques and focus their treatment based on the philosophy they were taught. But just because there’s a lot of noise in the discipline doesn’t mean a simpler way doesn’t exist. Orthodontic treatment can be systematic, and it can be scientific. You just have to know where to begin.

Dr Francesco Pedetta, author of New Straight Wire: Strategies and Mechanics for a Programmed Approach to Orthodontic Treatment, brings you the New Straight Wire (NSW) approach, an approach to orthodontics that uses the mathematics of the patient’s facial measurements to determine the amount of space available and therefore the appropriate treatment.

“For the orthodontist,” Dr Pedetta adds, “it’s a bit like thinking in reverse.”

A classically trained orthodontist, Dr Pedetta was not satisfied with the uncertainties and discretion in the treatments he was taught. As he explains it, “The NSW technique responds to a totally different way of dealing with orthodontics compared to the past.” Instead of focusing on where the molars should be, the NSW approach focuses on where the maxillary incisors should be for the patient’s smile and facial esthetics. “For the orthodontist,” Dr Pedetta adds, “it’s a bit like thinking in reverse.” By tracing the esthetic line, the ideal position of the incisors can be determined. After evaluating their initial position, “it is easy to identify the possibilities and limits of their movement in the desired direction. Sometimes it is possible, while other times further displacements cannot be made.” By starting at the front instead of the back, the esthetics take a primary role alongside function.

Unlike traditional cephalometric-based treatment models, where multiple points and planes must be marked and traced to determine the appropriate orthodontic movements, the NSW technique relies on six calculations:

The amount of movement (in mm) necessary to move the molars to a Class I relationship
The amount of crowding present
The depth of the curve of Spee
Any required tooth expansion (shape of the arch)
Any required palatal skeletal expansion
The required incisor movement

“The NSW table will indicate, as if by magic, how much to move the molars and premolars back.”

These calculations are outlined in points 1 to 6 of the NSW table, which is central to the NSW technique. Any internal problems (agenesis, peg lateral incisors, molar uprighting) and the need for any extractions complete the table, and together the table shows all of the movements and corrections necessary to resolve the orthodontic case. With this technique, molar correction, movement of the incisors, and flattening of the curve of Spee or potential maxillary expansion are all calculated before beginning treatment. Dr Pedetta explains it like this: “The NSW table will indicate, as if by magic, how much to move the molars and premolars back; for example, it will indicate whether stripping will be necessary and how much. The table will also indicate whether the case requires extractions to allow for ideal incisor position. This reasoned approach provides the answers an orthodontist needs to set up the treatment and to move confidently from its first steps.”

Once the table is completed, the sum of the discordance value is calculated and entered. This represents the existing space discordance after carrying out all movements and corrections considered necessary. If the sum equals 0, the movements are feasible and no space or crowding will be left over. If the sum is negative, an alternative plan must be considered, because there is not enough space to complete all the planned movements. If the sum is positive, the treatment plan is feasible but extra space will be left over and the gap must be closed with loss of molar and premolar anchorage. The goal is always to have a discordance value of 0. To achieve this, the NSW table has a second column for adjustments to the plan. Apart from the crowding, which is invariable, any of the other parameters can be changed to obtain a better overjet or an incisor position closer to the glabella.

Filling out the NSW table automatically creates a treatment plan, because it tells us how to move the teeth, by how much, and in what direction, allowing us to check the final result before beginning treatment. Systematic treatment planning made simple.

Filling out the NSW table automatically creates a treatment plan, because it tells us how to move the teeth, by how much, and in what direction, allowing us to check the final result before beginning treatment.

Dr Pedetta is confident that “once you learn the NSW technique, it will be impossible to go back to the traditional way of treatment planning, full of uncertainties, subjective assessments, and possible evaluation errors.” If you want better outcomes with more predictability in your orthodontic cases, preview the first chapter of New Straight Wire here.

Francesco Pedetta, MD, DDS, graduated in medicine and surgery with a postgraduate dentistry qualification in Italy. In 1991, he joined the prestigious Postgraduate School of Orthodontics at the University of Pennsylvania in Philadelphia, where he gained his Certificate of Orthodontics under the guidance of Dr Robert L. Vanarsdall. After returning to Italy, he set up a private practice limited exclusively to orthodontics and temporomandibular disorders but continued to lecture at the University of Pennsylvania as well as at Perugia University. In 2012, he met the master of orthodontics, Dr Larry Andrews, who initiated him into the 6 Elements philosophy, inspiring him to completely change his approach. Dr Pedetta then devoted himself to teaching this philosophy. He then went on to develop his personal orthodontic approach known as the New Straight Wire approach, which incorporated all of Andrews’s teachings in an up-to-date and effective method encompassing diagnosis, treatment planning, and therapy.

New Straight Wire: Strategies and Mechanics for a Programmed Approach to Orthodontic Treatment
Francesco Pedetta

This textbook seeks to simplify orthodontic diagnosis, treatment planning, and therapy by introducing the New Straight Wire (NSW) method. Using simplified cephalometry and treatment mechanics, this technique uses a table to systematically calculate and plan the necessary tooth movements before treatment, following the same parameters for each and every patient regardless of malocclusion. With the NSW technique, the treatment plan starts small and then moves to a larger scale, first carefully assessing the dental arches and then moving outward and analyzing their position on the patient’s face. The treatment is therefore “verified” before beginning; the teeth can be placed in the planned positions to check that the resulting occlusion satisfies esthetic and functional goals for each individual patient. This approach rules out treatment plans that lead to good occlusion to the detriment of facial harmony. This book therefore teaches how to achieve Class I molar occlusion with proper overjet and facial esthetics every time, regardless of the pretreatment condition. It clarifies when surgery is indicated and when dental compensations and compromises may be made instead. While orthodontics has historically been a specialty based on action and reaction, this book seeks to shift orthodontics to a practice based on systematic movements planned from the start.

Contents
1. Introduction to the New Straight Wire
2. The Treatment Plan
3. Arch Lines
4. Dental Movements: Translation and Tipping
5. Orthodontic Forces and Gap Closure
6. Skeletal Growth
7. Discordance
8. Class I Malocclusion Correction
9. Class II Malocclusion Correction
10. Class III Malocclusion Correction
11. NSW Cephalometric Analysis
12. Example Treatment Plan

Posted in Books, Misc, Orthodontics, What's New | Leave a comment

From Bleeding Edge to Mainstream: The Evolution of Tilted Implants

Posted on May 8, 2020 by Quintessence Publishing

Reading time: 6 minutes

Written by: Marieke Zaffron

Have you had a video conference recently with someone who clearly had no idea how to use the software? Maybe you wanted to check in on an elderly relative or have a virtual meeting with a colleague who communicates best face to face. It can be both amusing and frustrating to teach new technology to those who are resistant to it. After all, plenty of people got along just fine until now using only a phone, so why should they step outside their comfort zone? For those of us who constantly feel the need to upgrade to the latest model of smartphone, download the most innovative software, or order the new cutting-edge tablet, it may be difficult to understand why others in our lives don’t want to keep pace. How many of our parents or grandparents outright refused to purchase a smartphone 10 years ago but now rely on it like a lifeline? We can’t stop technology from moving forward, so what’s the point in resisting it?

This is how Dr Enrico Agliardi, MD, DDS, PhD, and Dr Davide Romeo, DDS, PhD, editors of Tilted Implants: Implant-Prosthetic Rehabilitation of the Atrophic Patient, feel about their preferred treatment protocol. The concept of tilting or angling implants, which is now a widely used option to treat partially and fully edentulous arches with techniques such as All-on-4, was initially rebuffed when it was first introduced by Dr Paulo Maló in the mid 2000s.

Even with a highly pneumatized sinus and an atrophic posterior bone crest, tilted implants allow anchorage into available bone with a reduced cantilever.

“Every clinician was taught to place implants axially for proper load distribution,” explains Dr Agliardi. After all, the Brånemark protocol for a full-arch fixed prosthesis had long-term studies and high success rates to back it up, so the protocol proposed by Dr Maló required a significant paradigm shift. Of course, herein lies the difference between the latest technology in our personal lives and the latest technology for patients—if you buy a new smartphone and it doesn’t work out, you wasted a few hundred dollars. If you place an implant in a way that doesn’t work out, you could cause harm to a patient.

Tilting implants, when done properly, results in the opposite of harm.

Yet, as the dental community slowly discovered over the last 15 years, tilting implants, when done properly, results in the opposite of harm. One of the initial concerns with tilted implants was that they might result in macromovements at the bone-to-implant interface and jeopardize the process of osseointegration; however, the evidence shows that tilted implants, especially those rigidly connected with axial implants, can reduce the amount of micromovements and result in successful osseointegration. So why haven’t tilted implants become part of every implant dentist’s armamentarium?

“Implant inclination can overcome anatomical limitations, allowing atrophic arches to be treated without resorting to bone grafting and with fewer biologic and economic costs.”

Perhaps, like those struggling with video conferencing software, clinicians just need more training on the proper methods. “We have to remember,” Dr Agliardi says, “that changing the way of doing implant dentistry all of a sudden—moving from established techniques such as sinus elevation and bone augmentation to new protocols—is always scary.” Yet, it may soon be necessary to face this fear. “In the near future, we are expecting an increasing number of patients—many of them systemically compromised, already edentulous, or with a periodontally failing dentition—who can benefit from immediate loading protocols that use residual native bone. Implant inclination,” Dr Agliardi explains, “can overcome anatomical limitations, allowing atrophic arches to be treated without resorting to bone grafting and with fewer biologic and economic costs.” Much like the current pandemic pushed people into using already available video conferencing software before they may otherwise have adopted it, the aging population will likely push clinicians to adopt these protocols for the sake of their patients’ overall health.

This patient’s mandible was very severely resorbed, but it was still possible to place enough implants for a full-arch prosthesis by tilting them and using the bone available.

Dr Romeo encourages anyone who doesn’t fully understand the benefits of these protocols to do a deep dive into the scientific literature and then “enroll in a hands-on course to practice the surgical phase and better understand the restorative protocols. Plan and execute your first cases together with a colleague who has performed the procedure before with success. Then, see if it works in your hands and get feedback from your patients.” If the surgical procedure is performed correctly, with an optimal distribution of the implant platforms, “this facilitates the restorative portion and allows for a functional and esthetically pleasing prosthesis that can be properly maintained by the patient.”

Of course, tilted implants shouldn’t replace the ability of the clinician to diagnose and treatment plan. There are still situations when straight implants or sinus augmentation is indicated as a preferred treatment option. Just like sometimes a video conference is necessary to get information across, while other times a phone call or email will suffice. But the best decision can’t be made unless all of the available options are explored. Tilted implants will be there when we need them, and thanks to Dr Agliardi and Dr Romeo’s continued research, clinicians now have an excellent resource for how to apply them when the time comes.

To preview the first chapter of Dr Agliardi and Dr Romeo’s new book, click here.

Enrico Agliardi, MD, DDS, PhD, graduated with honors from the University of Milan in 1994, specializing in medicine and surgery. At the same university, he attained a specialization in maxillofacial surgery in 2000 and a specialization in orthodontics in 2005. Since 2009, Dr Agliardi has been in charge of the Special Rehabilitation Surgery department at the Department of Dentistry of IRCCS San Raffaele of Milan, and he is also a professor in the Special Rehabilitation Surgery Department at Vita-Salute San Raffaele University. For over 15 years, he has been involved in the implant-prosthetic rehabilitation of compromised patients with tilted and zygomatic implants.

Davide Romeo, DDS, PhD, graduated with honors from the University of Milan in 2005, specializing in dentistry and dental prosthetics and with a thesis on the clinical efficacy of the All-on-4 protocol. He later obtained a doctorate from research in innovative techniques in oral implantology and implant-prosthetic rehabilitation, attending the dental clinic of the Galeazzi Institute of Milan before completing a year of study in periodontology at the Department of Periodontology and Implantology at New York University. He has been collaborating with Dr Enrico Agliardi for 14 years, carrying out clinical and research activities on immediate and partial and complete rehabilitations.

Tilted Implants: Implant-Prosthetic Rehabilitation of the Atrophic Patient
Edited by Enrico Agliardi and Davide Romeo

When presented with atrophic arches, clinicians often turn to invasive techniques such as bone grafting or maxillary sinus augmentation. However, using tilted implants instead can avoid these aggressive procedures, allowing the implant support to be moved posteriorly and for longer implants to be chosen. The implants can be loaded immediately to support a full-arch fixed prosthesis in multiple configurations, such as All-on-4, transsinus implants, zygomatic implants, or the authors’ signature V-II-V technique. This book first presents the science and clinical evidence behind the various protocols using tilted implants, then proceeds to discuss patient evaluation, diagnostics, and planning before diving into the methods themselves. Procedures are discussed separately for each arch, highlighted by dozens of clinical cases representing a diverse range of initial situations. In addition to the surgical protocols, methods for fabricating provisional and definitive prostheses are laid out with each step illustrated and explained. This comprehensive volume truly covers everything a clinician needs to know to use tilted implants with great success for their patients.

Contents

The Biology of Osseointegration
Osseointegration in Immediate Loading
Immediate Loading with Tilted Implants
Advantages of Tilting Dental Implants
Evaluation of Edentulous Patients
Diagnostics and Planning for Complex Rehabilitation
Rehabilitation of the Compromised Patient
Rehabilitation Protocols for the Maxilla
Rehabilitation Protocols for the Mandible
Provisional Prosthetic Solutions
Definitive Prosthetic Solutions

Posted in Books, Implant Dentistry, Oral and Maxillofacial Surgery, Prosthodontics, What's New | Leave a comment

PRF and Its Many Talents

Posted on May 1, 2020 by Quintessence Publishing

Reading time: 8 minutes

Facial esthetics has become one of the fastest-growing industries in the world, and in the United States roughly 9% of dentists are already performing elective cosmetic procedures. As the field continues to evolve and patients demand more and more of practitioners, it is clear that both the beginner as well as the advanced practitioner seek convenient, safe, and effective therapies. Platelet-rich fibrin is an ideal biomaterial in this sense because it is entirely natural—derived from a person’s own blood—and can be administered start to finish in as little as 35 minutes. Dr Richard J. Miron, biomaterials researcher and coauthor of PRF in Facial Esthetics (with Dr Catherine Davies), knows that the potential for PRF in facial esthetics is vast, and he’s excited to see what the future brings. Read on to learn what he has to say about PRF and its future, specifically in facial esthetics.

Syringe with collected liquid PRF ready for future facial injection purposes.

How does PRF differ from facial fillers?

Facial fillers are literally trying to “fill” facial voids, whereas PRF is trying to regenerate tissues naturally.

Facial fillers are literally trying to “fill” facial voids, whereas PRF is trying to regenerate tissues naturally. Definitely between the two, the use of PRF is more natural, but of course fillers offer that “wow!” factor, where a more dramatic change can be achieved quickly. PRF is typically favored for the newbie patient just entering the field with a desire to achieve a more youthful look. These patients are excellent candidates because many are not looking for dramatic and unnatural changes, and they will appreciate knowing that the biomaterial utilized is entirely derived from natural sources. Everyone should consider this as a first option before jumping the gun on fillers or toxins that may offer more permanent changes undesired by patients.

Why should people consider incorporating PRF into their arsenal of facial esthetics?

Safety first. Especially for doctors who are just entering the field, I can’t think of a better way to learn injection techniques than to utilize a completely natural product with fewer risks. Fillers and toxins each possess a risk for allergic reactions, which can be a bit intimidating for both the new practitioner as well as the new patient. Worldwide the number of individuals with allergies has grown due to the increase of exposure to unnatural chemical derivatives, and many biomaterials/fillers are loaded with a variety of them. Therefore, having the training and skill to utilize PRF in facial esthetics to cater to those who desire a natural treatment alternative is essential and results in a variety of treatment options that serve the entire community.

What are the most exciting applications of PRF?

Personally, I feel that microneedling with PRF is the “bread and butter” of the applications because the procedure is easy, straightforward, and consistently leads to good esthetic results. I can’t think of a single patient who has ever been disappointed from the procedure, and there are literally minimal risks associated with the procedure.

Microneedling with PRF is the “bread and butter” of the applications because the procedure is easy, straightforward, and consistently leads to good esthetic results.

What’s the future of facial esthetics and PRF?

As someone who enjoys new, innovative technologies, I foresee two exciting avenues for the future. First, we have spent a considerable amount of time developing the Bio-Heat protocols, whereby the properties of PRF are extended from 2–3 weeks to 4–6 months simply by a heating process. Therefore, PRF can act more as a “biofiller” with extended working properties. We have had quite successful results with doctors incorporating this technology within their offices.

PRF naturally regenerates tissues, resulting in a natural-looking outcome.

Secondly, the combination of the Fotona laser with PRF has really opened my eyes to the power of energy. Amazingly, both technologies work via completely different modes of action and complement one another perfectly, while both remain entirely natural (no entry into the body of foreign molecules/chemicals). For me personally, I am a big believer in a natural treatment approach, which is why this combination working together synergistically is the most exciting for me. Truthfully, I hope there comes a day where better results are obtained with lasers and PRF in comparison to fillers and Botox. I don’t foresee this happening without the use of lasers, and I believe we have only scratched the surface of their full potential.

Dermal fillers fill tissues unnaturally, resulting in a less natural-looking appearance.

I think over the last decade people started to delve too far into the “unnatural look,” and this is partially a result of movie stars heading down that road. Today, more and more cultures around the world appreciate a more natural look, and this is much easier to achieve with an all-natural biomaterial like PRF combined with laser therapy, in comparison to the various fillers and toxins commonly utilized in today’s market.

I believe that dentists are in an ideal position to offer PRF and facial esthetic options to their patients.

I believe that dentists are in an ideal position to offer PRF and facial esthetic options to their patients. Owing to the huge demand and market (it’s a multibillion dollar industry, with many more dollars spent in the field comparatively), dentists are fully capable of slowly dominating the market over time. While there are “med spas” popping up at every major street corner in big cities like Los Angeles, Miami, and New York, I personally believe that dentists are in better positions to do injections as a result of doing them all day in a complex and more difficult area such as the mouth. We already have a substantial educational background in head and neck anatomy. I do not feel any other profession is better suited or qualified for the field of minimally invasive facial procedures.

With roughly 9% of American dentists already performing elective cosmetic procedures, there is a substantial amount of dental offices who are now profiting from performing such procedures (over 20,000). That trend is increasing year after year, and I only expect that it will continue and that there will come a day where cultures will accept that dentists are performing the majority of these procedures. This would be similar to what has occurred over the past 20 years with respect to sleep apnea, which is now commonly offered in various dental offices. Twenty years ago, it would have been considered a bit strange for a dentist to offer such a therapy, but today it is widely accepted. I believe the same will occur regarding dentists and facial esthetic procedures and that someday in the near future, they will be the leading practitioners in the field of minimally invasive facial esthetic procedures. This was the exact reason for writing this first textbook on this specific topic solely dedicated to minimally invasive and natural therapy with PRF!

Finding Your Feet with PRF

To learn more about how to incorporate this natural biomaterial into your existing facial esthetic practice, or to start from scratch, check out PRF in Facial Esthetics. Preview the first chapter here.

Beyond Facial Esthetics

If facial esthetics is not your thing, consider using PRF for its many other applications in dentistry, including ridge augmentation, sinus grafting, and even endodontics. Drs Mohammad Sabeti, Edward S. Lee, and Mahmoud Torabinejad recently published PRF Applications in Endodontics. Preview the book here.

PRF in Facial Esthetics
Catherine Davies and Richard J. Miron

Written in collaboration with international experts from various fields of medicine, including basic scientists, clinician-scientists, experts in laser therapy and photography, as well as plastic surgeons and hair restorative surgeons, this book collectively offers a comprehensive approach to using platelet-rich fibrin (PRF) in facial esthetics. PRF has been used for decades in regenerative medicine, and slowly it has made its way into the medical esthetic arena, often used in combination with other leading therapies to support minimally invasive esthetic procedures. This book therefore starts at the beginning, first exploring the biology and anatomy of the skin and hair before turning to a discussion of photographic record-keeping and patient consultation. Then follow chapters on the biology of platelet concentrates and microneedling, skin and hair regeneration, lasers, and the use of PRF in plastic surgery. The final chapter looks to the future and considers what else could be possible. If you perform any facial esthetic procedures in your office or want to learn how, this book is a must.

Contents
1. Introduction to Facial Esthetics and PRF
Richard J. Miron, Catherine Davies
2. Facial Anatomy, Skin Biology, and the Effects of Aging
Catherine Davies, Richard J. Miron
3. Photography in Facial Esthetics
Walter Rozen, Richard J. Miron, Catherine Davies
4. Consultation for the Facial Esthetic Patient
Richard J. Miron, Catherine Davies
5. Consultation for the Hair Loss Patient
Alan J. Bauman, Catherine Davies, Richard J. Miron
6. Use of Platelet-Rich Fibrin in Facial Esthetics
Richard J. Miron, Yufeng Zhang, Ana Paz, Masako Fujioka-Kobayashi, Catherine Davies
7. Biology of Microneedling
Erin Anderson, Nichole Kramer, Richard J. Miron, Ana Paz, Catherine Davies
8. Injection Techniques with Platelet-Rich Fibrin
Catherine Davies, Ana Paz, Alireza Panahpor, Ana Cristina, Richard J. Miron
9. Hair Regeneration with Platelet-Rich Fibrin
Catherine Davies, Richard J. Miron
10. Lasers in Facial Esthetics
Ana Paz, Harvey Shiffman, Miguel Stanley, Catherine Davies, Richard J. Miron
11. Skin Care Products and Their Effect on Aging Skin
Geir Håvard Kvalheim, Catherine Davies, Richard J. Miron
12. Future Trends in Esthetic Medicine
Carlos Fernando de Almeida Barros Mourão, Delia Tuttle, Ruth Delli Carpini, Scott Delboccio, Richard J. Miron, Catherine Davies

Catherine Davies, MBBCh, MBA, is a medical doctor practicing in Johannesburg, South Africa, with a special interest in esthetics, regenerative medicine, and hair restoration. She has over 14 years of experience in FUE hair transplant surgery. She is board certified in stem cell medicine from the A4M Academy in the United States. Dr Davies frequently lectures and trains on medical procedures and is passionate about medical education. She recently featured in and produced an international medical TV show called Outpatients, which is on its third successful season and airs in 180 countries. Her passion is to drive social change through the use of media. She is the proud mother of three children.

Richard J. Miron, DDS, BMSc, MSc, PhD, Dr med dent, is currently the lead educator and researcher at Advanced PRF Education and is Adjunct Visiting Faculty in the Department of Periodontology at the University of Bern in Switzerland, where he completed his PhD studies. He has published over 200 peer-reviewed articles and lectures internationally on many topics relating to growth factors, bone biomaterials, and guided bone regeneration. He is widely considered one of the top contributors to research in dentistry, having recently won the ITI André Schroeder Prize, the IADR Young Investigator of the Year in the field of implant dentistry, as well as the IADR Socransky Research Award in the field of periodontology. Dr Miron has written two best-selling textbooks in regenerative dentistry, including Next-Generation Biomaterials for Bone & Periodontal Regeneration (Quintessence, 2019), and he’s just getting started.

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5 Tips for Increasing Compliance with Kids

Posted on April 17, 2020 by Quintessence Publishing

Reading time: 8 minutes

Written by: Leah Huffman

Kids can certainly be a challenge. Ask any parent, teacher, or health care worker who interacts with them on a daily basis. Kids can be demanding, unpredictable, and sticky. But as pediatric dentist Ulrike Uhlmann points out, “They are also the most genuine and most grateful patients you can imagine. No ‘thank you’ or warm handshake will leave you quite as happy as the melted bar of chocolate shyly conjured out of a child’s backpack or the picture that a little patient has painted and proudly presents to you.” Whether they are chatty or shy, squirrelly or serious, kids can be the most appreciative and trusting of patients in the dentist office. And while not all dentists need to become pediatric dentists, all dentists are obliged to deal with or indeed treat their young patients responsibly. Here are 5 tips for increasing compliance with kids, curated from Dr Uhlmann’s new book, Dentistry for Kids: Rethinking Your Daily Practice.

“No ‘thank you’ or warm handshake will leave you quite as happy as the melted bar of chocolate shyly conjured out of a child’s backpack or the picture that a little patient has painted and proudly presents to you.”

1. Create a child-friendly environment.

In consideration of your other patients and the sanity of your staff, opt against any toys that make noise, and consider the cleansability of any toys you plan to have available for tiny hands.

Children need to be engaged to feel comfortable in any public space. A waiting area with chairs and magazines will not cut it for most kids. But that doesn’t mean you need much. A table with paper and crayons, some child-appropriate books (good ones, not the cheapest you can find!), and some building blocks or pretend play toys are sufficient. Just make sure they are placed at a level where the child can see them as soon as they enter your practice. Any pictures or wall decals should also be at child level. If space is a concern, wall-mounted drawing boards or magnetic toys can be a good alternative. In consideration of your other patients and the sanity of your staff, opt against any toys that make noise, and consider the cleansability of any toys you plan to have available for tiny hands.

In the treatment area, a photo or painting on the ceiling can dually fascinate young children and distract older, anxious patients. It’s also a good idea to keep air freshener on hand to eliminate the typical smells of the dental practice, which can unsettle or frighten some children.

2. Know that not all kids are the same.

Every child is unique, and every child comes with a different personality, a different home life, and a different set of emotions. That being said, it’s important to decipher which type of pediatric patient you have sitting in front of you to determine how best to interact with them. Some younger children will cry for no apparent reason, and for these little ones it might be a good idea to speak very quietly to arouse their interest and therefore calm them down. For extra shy patients, you may need to allow them extra time to get comfortable and gain the confidence to come out from behind mom or dad. It can often help with these patients to perform an examination first on a parent; while doing so, ignore the child completely and audibly communicate all findings to the dental assistant (for example, “I’ve counted eight of mommy’s teeth and they are lovely and sparkling”). Offering a prize to the parent for their cooperation may be enough to tempt the child to volunteer for or at least accept examination themselves. Know-it-alls can be a particular challenge, but straightforward conversation and blunt answers to questions can often nip any difficulty in the bud.

Perhaps the most difficult type of patient is the overly spoiled child or child of helicopter parents. These children are often petulant and confrontational, and the parents will often defend their child’s poor behavior. The best tools in this case are voice control (speaking calmly and quietly when the child is cooperating and more loudly and assertive when cooperation wanes) and clear rules expressed directly to the child (“This is my practice and in here we work by my rules. I’d like you to be nice to me and everyone working here—just as nice as you expect me to be. I cannot keep your teeth healthy if you disrespect me and mess with all of my instruments.”).

3. Respect personal space and use child-appropriate language.

A stuffed animal or toy can often act as a neutral mediator to encourage small children to allow the dentist to encroach on their personal space, and it can be used for demonstration purposes to allay any fears.

Children have the right to their personal space as much as any adult does, and dentists need to respect that. Any invasion to this space, whether with movements or even verbally, can result in anxiety or aggression because the child no longer feels safe and secure. Of course any dental examination or treatment requires some invasion of this personal space, so the trick lies in shrinking it enough and making the patient comfortable enough to allow that invasion. First of all, dentists and assistants should maintain an open smile, a calm manner, and nonjerky movements and read the signals coming from the child. Some children may require more time than others to get acquainted and let their guard down. A stuffed animal or toy can often act as a neutral mediator to encourage small children to allow the dentist to encroach on their personal space, and it can be used for demonstration purposes to allay any fears.

In addition, child-appropriate language must be used at all times. This means short sentences with concrete words that children can understand, like “tooth feeler” instead of “probe.” While a child’s imagination can certainly make some things seem scary, the dentist can also tap into it to change the narrative and make an otherwise-threatening object seem fun (for example, by creating a story around a given treatment step). It is also a good idea to avoid the word “okay” at the end of a sentence, because it can confuse children into thinking they are being asked a question, which is a problem if they answer with “no.”

4. Work with the child and PRAISE them when they cooperate.

A child is not a little adult, and it is important to remember that children have a MUCH shorter attention span than adults. Dr Uhlmann expects an attention span of about 5 minutes per year of life, which doesn’t add up to much for a 2- or 3-year-old sitting in the dental chair. Ask questions that engage their curiosity (“How many teeth do you think you have in there?”) to keep them attentive, and use whatever works for a given patient. For some children, a favorite stuffed animal or toy can make all the difference in the dental chair. It can be used for demonstration and bring comfort when the child gets anxious. For others, using their own toothbrush can make examination less scary, or watching an older sibling go first.

Even simple things like sitting in the dental chair should be acknowledged with praise to encourage the child to continue with the examination or treatment.

Most importantly, never underestimate the power of praise. Like adults, the more confidence a child feels, the better they will feel about themselves and their immediate circumstances. Offer praise in the form of positive words, high fives, or ringing of a special bell to let the child know that they are doing a good job listening and following instructions. Even simple things like sitting in the dental chair should be acknowledged with praise to encourage the child to continue with the examination or treatment. Even if the session does not go well, try to find something worthy of praise, like their willingness to open their mouth and let the dentist sneak a peek.

5. Make it fun!

“It’s all about fun! The more fun a kid has in your office, the more compliant he or she will be.”

As stated in Dr Uhlmann’s book, “It’s all about fun! The more fun a kid has in your office, the more compliant he or she will be. Make sure you have fun toys, you hand out cool prizes, and you engage the child in fun ways.” There is no limit to how creative you can be in your practice to make things fun for kids. From coloring contests to competitions for who can count the most clicks during anesthesia administration to ringing a bell when treatment is finished, opportunity is all around to make the dental practice a place of fun instead of fear or frustration.

Last but not least, be generous with prizes. Kids love free stuff, especially when they feel they’ve earned it, so they should be awarded a little prize at the end of each session.

Finally, be patient.

As humorist Franklin P. Jones once said, “You can learn many things from children. How much patience you have, for instance.” Whether it’s the screaming baby, the sticky-handed schoolchild, or the eye-rolling teenager, try to be patient. You may just get rewarded with a crumpled candy bar or perfect little-kid hug.

Ulrike Uhlmann, Dr med dent, studied dentistry at Leipzig University from 2005 to 2010. Even during her studies she showed a keen interest in children’s dentistry. After her examinations in 2010, she worked in Halle/Saale for 4 years, during which time she learned about and came to love the whole gamut of pediatric dentistry. Interdisciplinary work with midwives, pediatricians, and speech therapists was and is a cornerstone of her professional ethos. At present she works on the staff of a family dental practice in Leipzig. As a speaker, she is also involved in the continuing professional development of midwives, speech therapists, educators, and other related professional groups in the field of pediatric dentistry. Together with a Leipzig midwives practice, she has also launched a parents workshop where relevant topics concerning children’s oral health are explained to pregnant women and parents, raising their awareness. She is married and has four children.

Dentistry for Kids: Rethinking Your Daily Practice
Ulrike Uhlmann

The practice of pediatric dentistry requires a broad knowledge of dentistry, orthodontics, nutritional sciences, and last but not least, psychology. The goal is to enable our young patients to live with the healthiest teeth possible, and this involves understanding how to embrace the opportunity, challenge, and responsibility of ensuring an ideal start for even the tiniest of our patients. This book presents the fundamentals of pediatric dentistry and explains how to incorporate them into an existing dental practice. Because parents are a crucial part of the equation, particular focus is given to educating and managing parents to be the best advocate for their children’s oral health. While the book is a useful reference for everyday practice in terms of examination, diagnostics, and findings, it goes further to include tips on how to create a child-friendly environment, how to communicate with young patients, and how to handle difficult situations with uncooperative patients or parents. The second half of the book is given over to treatment considerations, spanning from preventive treatment like fluorides and sealants to filling and crown therapy. This final chapter also includes sections on antibiotic use, managing trauma, sedation, and other particular challenges in everyday practice. This book is an essential resource for anyone working with kids in dentistry.

Contents
1. Introduction and Basics
2. Successful Communication with Kids and Parents
3. Educating Parents: Oral Hygiene and Prophylaxis
4. Dental Examination and Tips for Increasing Compliance
5. Diagnostics in Pediatric Dentistry
6. Findings
7. Treatment Considerations and Approaches
Epilogue

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